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远端胆管癌微创治疗的争议与技术要点

外科理论与实践 2021年第2期26卷 120-123页

作者：陈丹磊邵成浩海军军医大学附属长征医院胰胆外科上海200003

远端胆管癌是胆总管末端、靠近Vater壶腹部的胆管恶性肿瘤,占所有胆管癌的20%~40%。胰十二指肠切除术(pancreaticoduodenectomy,PD)是远端胆管癌的唯一根治手段[1]。近年来,微创技术和器械不断进步,腹腔镜PD(laparoscopic PD,LPD)发展迅... 详细信息

远端胆管癌是胆总管末端、靠近Vater壶腹部的胆管恶性肿瘤,占所有胆管癌的20%~40%。胰十二指肠切除术(pancreaticoduodenectomy,PD)是远端胆管癌的唯一根治手段[1]。近年来,微创技术和器械不断进步,腹腔镜PD(laparoscopic PD,LPD)发展迅速,并越来越多地应用于远端胆管癌的治疗[2-3]。

关键词：远端胆管癌腹腔镜胰十二指肠切除术

右半结肠切除联合胰十二指肠切除术的价值和争议

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结直肠肛门外科 2023年第4期29卷 328-331页

作者：邓小巍邵成浩海军军医大学第二附属医院(上海长征医院)胰胆外科上海200003

整块多脏器联合切除术(包括胰十二指肠切除术和右半结肠切除术)被认为是无远处转移的局部晚期右半结肠癌侵犯胰腺和/或十二指肠的最佳治疗策略。由于右半结肠癌的生物学行为相对较好,在没有远处转移的情况下,R0切除对患者的收益是显而... 详细信息

整块多脏器联合切除术(包括胰十二指肠切除术和右半结肠切除术)被认为是无远处转移的局部晚期右半结肠癌侵犯胰腺和/或十二指肠的最佳治疗策略。由于右半结肠癌的生物学行为相对较好,在没有远处转移的情况下,R0切除对患者的收益是显而易见的。但因为手术难度较大、风险高,目前针对局部晚期右半结肠癌侵犯胰腺和/或十二指肠的治疗方案并没有达成共识。本文从切除范围、并发症风险及来源、偏倚分析和新辅助治疗的应用等方面分析整块多脏器联合切除术治疗局部晚期右半结肠癌的价值和争议。

关键词：右半结肠癌整块多脏器联合切除术右半结肠切除术胰十二指肠切除术

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胰腺腺鳞癌80例临床诊治分析

中华外科杂志 2014年第9期52卷 658-661页

作者：宋彬刘晓彬马洪运纪伟平邵成浩胡先贵金钢第二军医大学长海医院胰腺外科上海200433

目的探讨胰腺腺鳞癌的病例特点及诊治方法.方法收集2003年12月至2011年10月第二军医大学附属长海医院胰腺外科收治的80例胰腺腺鳞癌患者的临床资料,男性61例,女性19例,年龄28 ～ 81岁,平均60岁.其中首发症状为腹胀不适46例（57.5％）... 详细信息

目的探讨胰腺腺鳞癌的病例特点及诊治方法.方法收集2003年12月至2011年10月第二军医大学附属长海医院胰腺外科收治的80例胰腺腺鳞癌患者的临床资料,男性61例,女性19例,年龄28 ～ 81岁,平均60岁.其中首发症状为腹胀不适46例（57.5％）、腰背部痛6例（7.5％）、腹部胀痛伴腰背痛4例（5.0％）、腹部胀痛伴黄疸15例（18.8％）、无痛性黄疸5例（6.3％）、体重明显减轻3例（3.8％）、无症状体检发现1例（1.3％）.所有患者术前均通过超声、增强CT或MRI证实为胰腺占位.其中肿瘤位于胰头及钩突者43例,位于胰体者15例,位于胰尾者22例.术后24个月内经门诊定期复诊或每3个月电话随访患者健康状况.结果 80例患者中,接受胰十二指肠切除术19例、保留幽门的胰十二指肠切除术19例、全胰切除术1例、姑息性手术4例.术中出血量50～3 500 ml,术中及术后输血量0～4000 ml.胰十二指肠切除术手术时间90～260 min,胰体尾脾切除术手术时间60 ～ 150 min.术后病理检查结果显示,肿瘤平均最大径（4.9±2.2）cm,35例伴周围淋巴结转移,35例伴胃、十二指肠等周围脏器侵犯,68例侵犯周围神经.术后发生并发症18例,包括腹腔内出血、胰漏、胃排空障碍、切口脂肪液化或感染、胸腔积液、腹腔积液和神经性腹泻.术后48例患者获得有效随访,其中术后16例患者接受化疗,8例患者接受放疗.获得随访的患者均死亡,术后中位生存时间6个月（0.1～23.0个月）.结论胰腺腺鳞癌是一种较少见的胰腺恶性肿瘤,患者大部分伴周围神经侵犯,该病预后差,目前主要治疗手段为手术治疗及放化疗.

关键词：胰腺肿瘤诊断治疗腺鳞癌

Consensus on the clinical diagnosis and treatment of grade 3 pancreatic neuroendocrine tumors

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Journal of Pancreatology 2024年第2期7卷 97-105页

作者： Jie Chen Wenming Wu Chunmei Bai Yihebali Chi Li Huo Liming Jiang Yuan Ji Jie Luo Jie Li Jingnan Li Wenhui Lou chenghao shao Lin Shen Feng Wang Yu Wang Ling Xue Jin Xu Chunhui Yuan Xianjun Yu Xiaoyu Yin Hong Zhao Xiongzeng Zhu Yupei Zhao Centre for Neuroendocrine Tumors Fudan University Shanghai Cancer CenterShanghai 200032China Department of General Surgery State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100730China Department of Medical Oncology Peking Union Medical College HospitalChinese Academy of Medical Science&Peking Union Medical CollegeBeijing 100730China Department of Medical Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Nuclear Medicine State Key Laboratory of Complex Severe and Rare DiseasesBeijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear MedicinePeking Union Medical College HospitalChinese Academy of Medical SciencesBeijing 100730China Department of Diagnostic Radiology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Pathology Zhongshan HospitalFudan UniversityShanghai 200032China Department of Pathology China-Japan Friendship HospitalBeijing 100029China Department of Gastroenterological Oncology Beijing Cancer HospitalPeking University Cancer Hospital&InstituteBeijing 100142China Department of Gastroenterology Peking Union Medical College HospitalPeking Union Medical CollegeChinese Academy of Medical SciencesBeijing 100730China Department of Pancreatic Surgery Zhongshan HospitalFudan UniversityShanghai 200032China Department of Pancreatic-Biliary Surgery Second Affiliated Hospital of Naval Medical UniversityShanghai 200003China Department of Gastrointestinal Oncology Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education)Peking University Cancer Hospital&InstituteBeijing 100142China Department of Nuclear Medicine Nanjing First HospitalNanj

The World Health Organization(WHO)2017 classifications for neuroendocrine neoplasms(NENs)subdivided grade 3 pancreatic neuroendocrine neoplasms(pNENs)into G3 well-differentiated pancreatic neuroendocrine tumors(G3 pNETs)and poorly differentiated pancreatic neuroendocrine carcinomas(pNECs),according to the mitotic count,Ki-67 index,and cell *** a new category,G3 pNETs remain a challenging group of tumors to manage by lacking large randomized trials and consensus to support its clinical ***,the Chinese Pancreatic Surgery Association,Chinese Society of Surgery,Chinese Medical Association gathered experts in this field to formulate this consensus for the diagnosis and treatment of G3 pNETs.

关键词： Clinical diagnosis Grade 3 Pancreatic neuroendocrine tumors Treatment

胰十二指肠切除术在慢性胰腺炎治疗中的应用价值及疗效

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上海医学 2010年第11期33卷 1003-1005页

作者：金钢胡先贵张怡杰刘瑞邵成浩何天霖李刚经纬宋彬第二军医大学附属长海医院胰腺外科上海200433

目的探讨胰十二指肠切除术在慢性胰腺炎治疗中的应用价值及疗效。方法回顾性分析第二军医大学附属长海医院1992年3月—2007年7月行胰十二指肠切除术(PD)治疗且术后证实为慢性胰腺炎的106例患者的临床资料,男87例,女19例,平均年龄为(51.2... 详细信息

目的探讨胰十二指肠切除术在慢性胰腺炎治疗中的应用价值及疗效。方法回顾性分析第二军医大学附属长海医院1992年3月—2007年7月行胰十二指肠切除术(PD)治疗且术后证实为慢性胰腺炎的106例患者的临床资料,男87例,女19例,平均年龄为(51.2士1 2.2)岁。73例(68.9%)患者获得随访,平均随访时间为(41.3±29.6)个月。分析本组慢性胰腺炎患者施行PD的适应证及手术的近、远期疗效。结果 PD的手术适应证主要为肿块型慢性胰腺炎,不能除外肿瘤、经内科治疗不能缓解的顽固性腹痛,合并胆道或十二指肠梗阻及内镜介入治疗失败等。本组无1例患者因手术死亡,术后并发症发生率为15.1%(16/106)。术后新发糖尿病7例,脂肪泻5例,死亡7例(其中3例死于慢性胰腺炎并发症,2例死于胰腺癌,2例死于心肺疾病)。结论在严格控制手术适应证的前提下,PD治疗胰头部慢性胰腺炎的手术疗效较好,对提高患者的生活质量和控制疾病进程具有一定的临床应用价值。

关键词：慢性胰腺炎,外科胰十二指肠切除术疗效

Whipple术中对异位起源于肠系膜上动脉并绕门静脉后方上行的肝总动脉的处理方法

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中华肝胆外科杂志 2014年第5期20卷 366-369页

作者：欧阳柳刘安安宋彬郝骏彭智勇梁兴邵成浩金钢胡先贵第二军医大学附属长海医院胰腺外科上海200433

目的探讨在Whipple术中保护异位起源于肠系膜上动脉并绕门静脉后方上行的肝总动脉的方法。方法回顾性分析第二军医大学附属上海长海医院胰腺外科2011年9月至2013年5月4例Whipple手术资料。4例患者肝总动脉均异位起源于肠系膜上动脉并绕... 详细信息

目的探讨在Whipple术中保护异位起源于肠系膜上动脉并绕门静脉后方上行的肝总动脉的方法。方法回顾性分析第二军医大学附属上海长海医院胰腺外科2011年9月至2013年5月4例Whipple手术资料。4例患者肝总动脉均异位起源于肠系膜上动脉并绕门静脉后方上行，总结避免此种异位肝总动脉损伤的方法。结果按照我们的方法，4例患者在Whipple术时均未损伤异位的肝总动脉。手术时间160～215min，平均192min。术中出血200～800ml，平均400ml。术中输血0～600ml，平均150ml。术后肝功能无明显变化。术后住院9—22d，平均17d，均顺利出院。结论在行Whipple术前，应了解肝总动脉的正常解剖及变异。术前行增强CT或CT血管造影（CTA）检查，并仔细读片，分析肝总动脉的起源及其走行；术中采取试夹闭“胃十二指肠动脉”，触摸“肝固有动脉”搏动，仔细解剖腹腔干根部，在解剖不清时不轻易切断任何一根血管等措施，可以有效避免此种异位肝总动脉的损伤。

关键词：解剖变异肝总动脉肠系膜上动脉胰十二指肠动脉 Whipple手术

Humification characterization of biochar and its potential as a composting amendment

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Journal of Environmental Sciences 2014年第2期26卷 390-397页

作者： Jining Zhang Fan L chenghao Luo Liming shao Pinjing He Institute of Waste Treatment & Reclamation State Key Laboratory of Pollution Control & Resource Reuse Tongji University

Biochar has received increasing attention due to its applications as a soil amendment. Here, the chemical properties of solid and water-extractable fractions of four biochar samples were investigated. The results showed that wood biochar and bamboo biochar samples were 60%-80% more hydrophobic than those of rice husk biochar and rice husk ash. In addition, the acidity was 3.88 mmol/g from the total functional groups and 1.03 mmol/g from the carboxyl groups/lactones/phenols found in the wood biochar sample, which were about 1.5 times greater than those of the bamboo biochar sample. These functional groups could be used to determine the sorptive capacity of biochar for ionic solutes and water content and to increase the degradation of compost organics. The wood biochar sample was found to have the most humification materials （fulvic acid-like material ＋ humic acid-like material） in the water-extractable fraction, which was 3-10 times higher than that in the rice husk biochar and rice husk ash; humified materials were not detected in the bamboo biochar sample. Humification materials in biochar may be involved in increasing the proportion of humic acid-like materials in humic-like substances within the compost product. Wood biochar had better hydrophobic, sorptive, aromatic, and humification properties compared to other biochars, suggesting that it may be used in composting in order to exert its effect as both a bulking agent and a composting amendment during the solid waste composting process.

关键词： biochar composting dissolved organic matter humification organic waste water-extraction

胰腺神经内分泌癌60例临床病理特征及外科治疗策略

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中华肝胆外科杂志 2014年第1期20卷 32-34页

作者：郑楷炼彭智勇胡先贵金钢邵成浩张怡杰周颖奇周旭宇刘瑞第二军医大学附属长海医院胰腺外科上海200433

目的探讨胰腺神经内分泌癌（PNEC）的临床病理学特征与外科治疗效果.方法回顾性分析长海医院1998年1月至2011年11月手术治疗的60例PNEC患者的临床病理学特征与外科治疗效果,采用log-rank检验比较根治性切除组与姑息性手术组患者生存情... 详细信息

目的探讨胰腺神经内分泌癌（PNEC）的临床病理学特征与外科治疗效果.方法回顾性分析长海医院1998年1月至2011年11月手术治疗的60例PNEC患者的临床病理学特征与外科治疗效果,采用log-rank检验比较根治性切除组与姑息性手术组患者生存情况之间的差异.结果60例患者中行根治性切除者50例,行姑息性手术者10例.根治性切除组5年生存率达51.5％,非根治性切除组的3年生存率为10.0％.根治性切除组的中位生存时间为61个月,非根治性切除组的中位生存时间为16个月（P＜0.01）.结论手术是治疗PNEC的首选方法,根治性切除组比姑息性切除组生存时间长.

关键词：胰腺肿瘤病理学外科手术存活率

The Chinese guidelines for the diagnosis and treatment of pancreatic neuroendocrine neoplasms(2020)

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Journal of Pancreatology 2021年第1期4卷 1-17页

作者： Wenming Wu Jie Chen Chunmei Bai Yihebali Chi Yiqi Du Shiting Feng Li Huo Yuxin Jiang Jingnan Li Wenhui Lou Jie Luo chenghao shao Lin Shen Feng Wang Liwei Wang Ou Wang Yu Wang Huanwen Wu Xiaoping Xing Jianming Xu Huadan Xue Ling Xue Yang Yang Xianjun Yu Chunhui Yuan Hong Zhao Xiongzeng Zhu Yupei Zhao on behalf of the Chinese Pancreatic Surgery Association Department of General Surgery State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science&Peking Union Medical CollegeBeijing Department of Gastroenterology The First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdong Province Department of Medical Oncology Peking Union Medical College HospitalChinese Academy of Medical Science&Peking Union Medical CollegeBeijing Department of Medical Oncology National Cancer CenterNational Clinical Research Center for CancerCancer HospitalChinese Academy of Medical Science&Peking Union Medical CollegeBeijing Department of Gastroenterology Changhai Hospital Affiliated to Navy Medical UniversityShanghai Department of Radiology The First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdong Province Department of Nuclear Medicine Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear MedicinePeking Union Medical College HospitalChinese Academy of Medical Science&Peking Union Medical CollegeBeijing Department of Ultrasound Peking Union Medical College HospitalChinese Academy of Medical Science&Peking Union Medical CollegeBeijing Department of Gastroenterology Peking Union Medical College HospitalChinese Academy of Medical Science&Peking Union Medical CollegeBeijing Department of General Surgery Zhongshan Hospital of Fudan University Department of Pathology China-Japan Friendship HospitalBeijing Department of Pancreatic-biliary Surgery Changzheng HospitalNavy Medical UniversityShanghai Department of Gastrointestinal Oncology Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education)Peking University Cancer Hospital&InstituteBeijing Department of Nuclear Medicine Nanjing First HospitalNanjing Medical UniversityNanjingJiangsu Province Department of Oncology Renji HospitalShanghai JiaoTong University School of MedicineShanghai Department of Endocrinology Peking Union Medical College HospitalChinese Academy of Medical Sc

Pancreatic neuroendocrine neoplasms(pNENs)are highly heterogeneous,and the management of pNENs patients can be *** address this challenge,an expert committee was established on behalf of the Chinese Pancreatic Surgery Association,which consisted of surgical oncologists,gastroenterologists,medical oncologists,endocrinologists,radiologists,pathologists,and nuclear medicine *** reviewing the important issues regarding the diagnosis and treatment of pNENs,the committee concluded evidence-based statements and recommendations in this article,in order to further improve the management of pNENs patients in China.

关键词： Diagnosis Guidelines Pancreatic Neuroendocrine Neoplasm Treatment